| BackgroundAutoimmune thyroid diseases, such as diffuse toxic goiter (Greaves disease) and lymphocytic thyroiditis (Hashimoto's thyroiditis), are more frequent in female after adolescence. The incidences of Greaves disease and Hashimoto's thyroiditis were about 0.02%~0.2% and 1/1600-1/2000 respectively. Maternal autoimmune thyroid disease may increase not only the incidence of complication in prenatal, but also the incidence of abnormal thyroid function in neonate. Moreover, without diagnosis and treatment early, it could cause the retardation of intellectual and physical development, and even deaths.The thyroid function in neonate and infant is close associated with intellectual development. In the last ten years, several studies reported that those neonates whose mother suffered with autoimmune thyroid diseases might increase the incidence of hypothyroidism (including primary or pituitary), hyperthyroidism and transitory hypothyroidism, that higher levels of thyroid stimulating hormone (TSH) receptor antibody (TRAb) were estimated in some of these neonates. These implied that the thyroid function of neonate maybe associated with some anti-thyroid auto-antibody. However, these previous studies consider with just one certain factor. In fact, these are many factors which maybe associated with the neonatal thyroid function, such as the pattern of maternal thyroid disease, the maternal thyroid function in pregnancy, thedrug used in pregnancy, other treatment, and so on. If these factors have any effect on neonatal thyroid function? If the thyroid function of mother and infant have effect on the intellectual development in neonate and infant? Which factors affect the infantile intellectual development? How about the degree of the effect? All these are needed to study deeply.ObjectiveIn this study, we investigated continuous the intellectual development of these infant whose mother suffered with autoimmune thyroid diseases in our province, study the association between the infant intellectual development and the maternal thyroid statue, and find the maternal risk factors associated with thyroid disease effect on the infant intellectual development.SubjectThrough the Zhejiang provincial neonatal disease screening network system, all the term newborn who born from mother with autoimmune thyroid disease (selection criteria) without asphyxia in all county, city, and provincial hospital in Zhejiang province (except Ningbo City) from July 2001 to June 2003 were enrolled. The control group was defined as the neonates who were born from mother without thyroid disease in these hospitals in the same time.Selection criteria: Hypothyroidism with the increased thyroid microsomal antibodies (TMAb), thyroid peroxides antibody (TPOAb), or thyroglobalin antibody (TGAb) which detected in city, and provincial hospital in gestation or before pregnancy were diagnosis as Hashimoto's thyroiditis. Hyperthyroidism supported with the thyroid ultrasonography or ECT scans or confirmed by fine-needle-aspirate biopsy of the thyroid, excluded the hyperfunctioning thyroid adenoma and multinodular goiter, were diagnosis as Graves disease.MethodsHeel capillary blood samples were collected from neonate older than 3 days in local hospitals and sent to the center of Zhejiang provincial neonatal disease screening network system. TSH levels were measured by Time difference fluorescent analysis device (1420 II type, American EGG Company). If the levels of TSH were over 9mU/L, the neonates and their mother were call back to the center in 3 days. If the levels of TSH was normal, they were call back to hospitals at age of 28 ~35 days. The pattern of maternal thyroid disease, duration, thyroid function, the history of maternal ingestion of drug, maternal age, gestation age and weight of the neonate were recoded. Re-measured the neonatal and maternal serum thyroid function and measured the serum TPOAb, TGAb, TRAb and TSAb levels both in neonate and their mother as well. A 1-year follow-up study was done and all these sub... |
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